Basic Information
Provider Information
NPI: 1922174911
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: TRUEX
FirstName: MICHELE
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: CRNA
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 804 SCOTT NIXON MEMORIAL DR
Address2:  
City: AUGUSTA
State: GA
PostalCode: 309072464
CountryCode: US
TelephoneNumber: 8003944445
FaxNumber: 7064348876
Practice Location
Address1: 2727 W DR MARTIN LUTHER KING JR BLVD
Address2: STE #310
City: TAMPA
State: FL
PostalCode: 336076383
CountryCode: US
TelephoneNumber: 8133507244
FaxNumber: 8133507246
Other Information
ProviderEnumerationDate: 11/28/2006
LastUpdateDate: 11/16/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
367500000XARNP657052FLY Physician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered 

No ID Information.


Home